Break the Cycle of Chronic Low Back Pain with Exercises Targeting the Multifidus
Chronic low back is a common problem that seems to flare up at the worst times. Break the cycle by understanding the multifidus muscles and the exercises to target these tiny muscles. The issue with recurrent low back pain is that the multifidus muscles associated with the injured segment has weakened and does not get stronger until exercises targeting the specific multifidus are initiated.
For example, if you have had an L5 disc herniation effecting the right side of your body. The right multifidus at L5 would be weak - creating instability of your spine at L5 - raising the risk of another episode of low back pain occurring...ARGH!
ANATOMY: The multifidus are paired muscles which run the length of your spine. They start at one spinous process and run diagonally to the segments 1-3 levels below. The picture below depicts how the multifidus muscles are the struts of your spine.
To work the strength of your low back multifidus muscles think of these exercises: options to do these exercises with or without the Hooked on Pilates® equipment are given.
1. HIP EXTENSION (lying flat on your stomach or on all fours)
2. TRUNK EXTENSION (with option to really get at your multifidus with extension of spine with rotation)
3. Work your CORE IN NEUTRAL SPINE
HIP EXTENSION: Could be done lying on your stomach flat on a mat. Lift straight leg up from the mat and hold for 5 seconds and for 3 sets of 15 reps....once you can do that add ankle weights or add resistance with a resistance band. The picture below demonstrates doing HIP EXTENSION on all fours (good option if lying flat on your stomach is uncomfortable) with resistance from the Hooked on Pilates® HANDIBANDS which adjust to your height and from there your can shorten them even more to increase more tension.
TRUNK EXTENSION: Lifting the torso while lying on your stomach (hold the position for 1-5 seconds shoot for 3 sets of 15 reps) is a great option for strengthening the Multifidus: TRUNK EXTENSION exercise below done on the MINIMAX which eases discomfort with lying flat on a mat but this exercise could be on a mat.
The picture below shows a client lifting her torso and rotating her left arm back to create the rotation to really target the left multifidus. She is halfway back with the arm rotation.
Try to do 3 sets of 15 and then you can add resistance with a hand weights or resistance bands. Below is a picture with resistance from the Hooked on Pilates® HANDIBANDS and you can also see more clearly the extension of the torso with rotation.
Finally working your CORE IN NEUTRAL SPINE: Think planks!!! The picture below demonstrates the Table Plank hold for 5-10 seconds and do 10 reps.
Finally there are a whole host of exercises done in neutral spine that you can do. I've got a video for beginners CORE WORK IN NEUTRAL SPINE on the the Hooked on Pilates® YouTube channel. Which will go over 10 exercises giving you a full body workout in NEUTRAL SPINE on the MINIMAX Here is the link to that video.
This blog is meant as information....please consult your healthcare provider as to the appropriateness for your specific medical condition. DO NOT DO ANY EXERCISE WHICH INCREASE YOUR PAIN - STOP AND SEEK MEDICAL ATTENTION!!! Be safe and healthy!!!